Early detection of COPD in a high-risk population using spirometric screening.

STUDY OBJECTIVES

To evaluate the efficacy of mass spirometry use for the detection of airflow obstruction in a high-risk population.

DESIGN

Free spirometry was offered to smokers who were > 39 years of age with a smoking history of > 10 pack-years. Action was preceded by the dissemination of information on the causes and symptoms of COPD in the local mass media.

SETTING

Pulmonary outpatient clinics in 12 large cities of Poland.

PARTICIPANTS

Eleven thousand twenty-seven subjects with the following characteristics were screened: mean (+/- SD) age, 51.8 +/- 12.5 years; men, 57%; current or ex-smokers, 80%; and mean smoking history, 26.1 +/- 16.8 pack-years.

INTERVENTIONS

Smoking history, simple spirometry (FVC and FEV(1)), and an antismoking advice.

RESULTS

Spirometric signs of airway obstruction were found in 24.3% of the subjects who were screened. Of those subjects, mild obstruction was found in 9.5%, moderate obstruction was found in 9.6%, and severe obstruction was found in 5.2%. In smokers aged > or = 40 years who had a smoking history of > 10 pack-years, airway obstruction was found in 30.6%. Airway obstruction was present in 8.3% of smokers < 40 years of age who had a smoking history of < 10 pack-years. Of the 2,200 subjects who had never smoked in their lives, airway obstruction was found in 14.4%.

CONCLUSIONS

Mass spirometry in high-risk groups is an effective and easy method for the early detection of COPD.